Early diagnosis of bilateral sub-deltoid bursitis using clinic-based ultrasonography in a patient receiving infliximab therapy for ulcerative pouchitis.
BACKGROUND
Infliximab, a monoclonal chimeric antibody to tumour necrosis factor (TNF)α, is a novel therapy used in the management of chronic refractory pouchitis that is unresponsive to conventional medical therapy.


METHODS
This report describes a case of non-infective bursitis following infliximab therapy and documents the role of musculoskeletal ultrasound in detecting soft tissue fluid collections and in guiding aspiration.


CONCLUSIONS
A high index of suspicion is required when assessing new or worsening musculoskeletal pain in patients receiving infliximab and involvement of a rheumatologist at an early stage is essential in order to appropriately diagnose and manage this condition.
Veerappan
S G
SG
Department of Gastroenterology, Adelaide & Meath Hospital, Tallaght, Dublin 24, Republic of Ireland. sveerappan@rcsi.ie
Moinuddin
G
G
Kennedy
M
M
O'Morain
C A
CA
Kane
D
D
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002062:Bursitis / Q000139:chemically induced* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000601:surgery; D057645:Deltoid Muscle / Q000000981:diagnostic imaging; D042241:Early Diagnosis; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000188:drug therapy*; D020069:Shoulder Pain / Q000209:etiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology; D014463:Ultrasonography
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab